Vagina

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This article is about the body part. For other uses, see Vagina (disambiguation)
.
Vagina
Scheme female reproductive system-en.svg
Diagram of the female human reproductive tract and ovaries
Vaginal opening description.jpg
Vulva with vaginal opening
1: Clitoral hood
2: Clitoris
3: Labium minorum (synonym: labium minus)
4: Urethral opening
5: Vaginal opening
6: Perineum
7: Anus
Details
Latin Vagina
Precursor
urogenital sinus and paramesonephric ducts
Artery
superior part to uterine artery, middle and inferior parts to vaginal artery
Vein
uterovaginal venous plexus, vaginal vein
Nerve
Sympathetic: lumbar splanchnic plexus
Parasympathetic: pelvic splanchnic plexus
Lymph
upper part to internal iliac lymph nodes, lower part to superficial inguinal lym
ph nodes
Identifiers
Gray's p.1264
MeSH
A05.360.319.779
Dorlands
/Elsevier
Vagina
TA
A09.1.04.001
FMA
19949
Anatomical terminology
The vagina is a fibromuscular tubular sex organ that is part of the female genit
al tract. In humans, the vagina extends from the vulva to the uterus. At the vul
va, the vaginal orifice may be partly covered by a membrane called the hymen, wh
ile, at the deep end, the cervix (neck of the uterus) bulges through the anterio
r wall of the vagina. The vagina facilitates sexual intercourse and childbirth.
It also channels the menstrual flow, consisting of blood and pieces of mucosal t
issue, that occurs periodically with the shedding of lining of the uterus in men
strual cycles.
The location and structure of the vagina varies among species, and may vary in s
ize within the same species. Unlike mammalian males, who usually have the urethr
al orifice as the sole external urogenital orifice, mammalian females usually ha
ve two external orifices, the urethral orifice for the urological tract and the
vaginal orifice for the genital tract. The vaginal orifice is much larger than t
he nearby urethral opening, and both openings are protected by the labia in huma
ns. In amphibians, birds, reptiles and monotremes, an opening called the cloaca
functions as a single external orifice for the gastrointestinal tract, urologica
l tract, and reproductive tract.
The vagina plays a significant role in human female sexuality and sexual pleasur
e. During sexual arousal for humans and other animals, vaginal moisture increase
s by way of vaginal lubrication, to reduce friction and allow for smoother penet
ration of the vagina during sexual activity. The texture of the vaginal walls ca

n create friction for the penis during sexual intercourse and stimulate it towar
d ejaculation, enabling fertilization. In addition, a variety of sexually transm
itted infections (STIs) and other disorders can affect the vagina. Because of th
e risk of STIs, health authorities and health care providers, recommend safe sex
practices.
Cultural perceptions of the vagina have persisted throughout history, ranging fr
om viewing the vagina as the focus of sexual desire, a metaphor for life via bir
th, inferior to the penis, or as visually unappealing or otherwise vulgar. Collo
quially, the word vagina is often used incorrectly to refer to the vulva.
Contents [hide]
1 Etymology and definition
2 Structure
2.1 Development
2.2 Layers, regions and histology
2.3 Vaginal opening and hymen
2.4 Variations and size
3 Function
3.1 Secretions
3.2 Sexual activity
3.3 Childbirth
3.4 Vaginal ecosystem and acidity
4 Clinical significance
4.1 General
4.2 Infections and disorders
4.3 Modification
5 Society and culture
5.1 Biological perceptions, symbolism and vulgarity
5.2 In contemporary art and literature
5.3 Reasons for vaginal modification
6 Other animals
7 See also
8 References
9 External links
Etymology and definition
The term vagina is from Latin vaginae, literally "sheath" or "scabbard"; the Lat
inate plural of vagina is vaginae,[1] and the vagina may be referred to as the b
irth canal in the context of pregnancy and childbirth.[2][3] Although by its dic
tionary and anatomical definitions, the term vagina refers exclusively to the sp
ecific internal structure, it is colloquially used to refer to the vulva or to b
oth the vagina and vulva.[4][5] Using the term vagina to mean "vulva" can pose m
edical or legal confusion; for example, a person's interpretation of its locatio
n not matching another person's interpretation of the location.[4] Medically, th
e vagina is the muscular canal between the hymen (or remnants of the hymen) and
the cervix, while, legally, it begins at the vulva (between the labia).[4]
Structure
Development
A precursor to the inferior portion of the vagina, called the vaginal plate, is
the growth of tissue that gives rise to the formation of the vagina; it is locat
ed where the solid tips of the paramesonephric ducts (Mllerian ducts) enter the d
orsal wall of the urogenital sinus as the Mllerian tubercle. The plate's growth i
s unrestrained, as it significantly separates the cervix and the urogenital sinu
s; eventually, the central cells of the plate break down to form the vaginal lum
en.[6] Until twenty to twenty-four weeks of pregnancy, the vagina is not fully c
analized. If it fails to fully canalize, this may result in various forms of sep
tae, which cause obstruction of the outflow tract later in life.[6]
In the absence of testosterone during sexual differentiation (sex development of

the differences between males and females), the urogenital sinus persists as th
e vestibule of the vagina, the two urogenital folds (elongated spindle-shaped st
ructures that contribute to the formation of the urethral groove on the belly as
pect of the genital tubercle) form the labia minora, and the labioscrotal swelli
ngs enlarge to form the labia majora.[7][8]
The human vagina develops into an elastic muscular canal that extends from the v
ulva to the uterus.[9][10] It is reddish pink in color, and it connects the supe
rficial vulva to the cervix of the deep uterus. The vagina is posterior to the u
rethra and bladder, and reaches across the perineum superiorly and posteriorly t
oward the cervix; at approximately a 90 degree angle, the cervix protrudes into
the vagina.[11] The vaginal orifice and urethral opening are protected by the la
bia.[12]
There exists debate as to which portion of the vagina is formed from the Mllerian
ducts and which from the urogenital sinus by the growth of the sinovaginal bulb
.[6][13] Dewhurst's Textbook of Obstetrics and Gynaecology states, "Some believe
that the upper four-fifths of the vagina is formed by the Mllerian duct and the
lower fifth by the urogenital sinus, while others believe that sinus upgrowth ex
tends to the cervix displacing the Mllerian component completely and the vagina i
s thus derived wholly from the endoderm of the urogenital sinus." It adds, "It s
eems certain that some of the vagina is derived from the urogenital sinus, but i
t has not been determined whether or not the Mllerian component is involved."[6]
Layers, regions and histology
An illustration showing a cut-away portion of the vagina and upper female genita
l tract (only one ovary and fallopian tube shown). Circular folds (also called r
ugae) of vaginal mucosa can be seen
Medium-power magnification micrograph of a H&E stained slide showing a portion o
f a vaginal wall. Stratified squamous epithelium and underling connective tissue
can be seen. The deeper muscular layers are not shown. The black line points to
a fold in the mucosa.
The wall of the vagina from the lumen outwards consists firstly of a mucosa of n
on-keratinized stratified squamous epithelium with an underlying lamina propria
of connective tissue, secondly a layer of smooth muscle with bundles of circular
fibers internal to longitudinal fibers, and thirdly an outer layer of connectiv
e tissue called the adventitia. Some texts list four layers by counting the two
sublayers of the mucosa (epithelium and lamina propria) separately.[14][15] The
lamina propria is rich in blood vessels and lymphatic channels. The muscular lay
er is composed of smooth muscle fibers, with an outer layer of longitudinal musc
le, an inner layer of circular muscle, and oblique muscle fibers between. The ou
ter layer, the adventitia, is a thin dense layer of connective tissue, and it bl
ends with loose connective tissue containing blood vessels, lymphatic vessels an
d nerve fibers that is present between the pelvic organs.[11][15][16]
Folds of mucosa (or vaginal rugae) are shown in the front third of a vagina
A normal cervix of an adult as seen through the vagina (per vaginam or PV) using
a bivalved vaginal speculum. The blades of the speculum are above and below and
stretched vaginal walls are seen on the left and right.
The mucosa forms folds or rugae, which are more prominent in the caudal third of
the vagina; they appear as transverse ridges and their function is to provide t
he vagina with increased surface area for extension and stretching. Where the va
ginal lumen surrounds the cervix of the uterus, it is divided into four continuo
us regions or vaginal fornices; these are the anterior, posterior, right lateral
, and left lateral fornices.[9][10] The posterior fornix is deeper than the ante
rior fornix.[10] While the anterior and posterior walls are placed together, the

lateral walls, especially their middle area, are relatively more rigid; because
of this, they vagina has a H-shaped cross section.[10] Behind, the upper one-fo
urth of the vagina is separated from the rectum by the recto-uterine pouch. Supe
rficially, in front of the pubic bone, a cushion of fat called the mons pubis fo
rms the uppermost part of the vulva.
Supporting the vagina are its upper third, middle third and lower third muscles
and ligaments. The upper third are the levator ani muscles (transcervical, puboc
ervical) and the sacrocervical ligaments; these areas are also described as the
cardinal ligaments laterally and uterosacral ligaments posterolaterally. The mid
dle third of the vagina concerns the urogenital diaphragm (also described as the
paracolpos and pelvic diaphragm). The lower third is the perineal body; it may
be described as containing the perineal body, pelvic diaphragm and urogenital di
aphragm.[9][17]
The epithelial covering of the cervix is continuous with the epithelial lining o
f the vagina. The vaginal mucosa is absent of glands. The vaginal epithelium con
sists of three rather arbitrary layers of cells[18]
superficial flat cells, int
ermediate cells and basal cells
and estrogen induces the intermediate and super
ficial cells to fill with glycogen. The superficial cells exfoliate continuously
and basal cells replace them.[10][19][20] Under the influence of maternal estro
gen, newborn females have a thick stratified squamous epithelium for two to four
weeks after birth. After that, the epithelium remains thin with only a few laye
rs of cells without glycogen until puberty, when the epithelium thickens and gly
cogen containing cells are formed again, under the influence of the girl's risin
g estrogen levels. Finally, the epithelium thins out during menopause onward and
eventually ceases to contain glycogen, because of the lack of estrogen.[10][20]
[21] In abnormal circumstances, such as in pelvic organ prolapse, the vaginal ep
ithelium may be exposed becoming dry and keratinized.[22]
For blood and nerve supply, relevant arteries are the cervicovaginal (the uterin
e cervix and the vagina) branch of the uterine artery, the vaginal artery, middl
e rectal artery, and the internal pudendal artery. The veins are connected by an
astomosis (the connection of separate parts of a branching system to form a netw
ork), resulting in the formation of the anterior and posterior azygos (unpaired)
arteries. The nerve supply of the vagina is provided by the sympathetic and par
asympathetic areas of the pelvic plexus, with the pudendal nerve supplying the l
ower area.[10]
Vaginal opening and hymen
The vaginal opening (or orifice or introitus) is at the caudal end of the vulva,
behind the opening of the urethra, resting at the posterior end of the vestibul
e. It is closed by the labia minora in female virgins and in females who have ne
ver given birth (nulliparae), but may be exposed in females who have given birth
(parous females).[10]
The hymen is a membrane of tissue that surrounds or partially covers the vaginal
opening.[10] The effects of vaginal intercourse and childbirth on the hymen are
variable. If the hymen is sufficiently elastic, it may return to nearly its ori
ginal condition. In other cases, there may be remnants (carunculae myrtiformes),
or it may appear completely absent after repeated penetration.[23] Additionally
, the hymen may be lacerated by disease, injury, medical examination, masturbati
on or physical exercise. For these reasons, it is not possible to definitively d
etermine whether or not a girl or woman is a virgin by examining her hymen.[23][
24]
Variations and size
Main article: Human vaginal size
Pelvic anatomy including organs of the female reproductive system

In its normal state, there is anatomical variation in the length of the vagina o
f a woman of child-bearing age. The length is approximately 7.5 cm (2.5 to 3 in)
across the anterior wall (front), and 9 cm (3.5 in) long across the posterior w
all (rear), making the posterior fornix deeper than the anterior.[10][16] During
sexual arousal, the vagina expands in both length and width. If a woman stands
upright, the vaginal tube points in an upward-backward direction and forms an an
gle of approximately 45 degrees with the uterus and of about 60 degrees to the h
orizontal.[10][17] The vaginal opening and hymen also vary in size; in children,
although a common appearance of the hymen is crescent-shaped, many shapes are p
ossible.[10][25]
Function
Secretions
The vagina provides a path for menstrual blood and tissue to leave the body. In
industrial societies, tampons, menstrual cups and sanitary napkins may be used t
o absorb or capture these fluids. Vaginal secretions are primarily from the uter
us, cervix, and transudation of the vaginal epithelium in addition to miniscule
vaginal lubrication from the Bartholin's glands upon sexual arousal. It takes li
ttle vaginal secretion to make the vagina moist. The secretions may be minor in
excess during sexual arousal, the middle of the menstrual cycle, a little prior
to menstruation, or during pregnancy.[10]
The Bartholin's glands, located near the vaginal opening and cervix, were origin
ally thought to be the primary source for vaginal lubrication, but they provide
only a few drops of mucus for vaginal lubrication;[26] the significant majority
of vaginal lubrication is generally believed to be provided by plasma seepage fr
om the vaginal walls, which is called vaginal transudation. Vaginal transudation
, which initially forms as sweat-like droplets, is caused by vascular engorgemen
t of the vagina (vasocongestion); this results in the pressure inside the capill
aries increasing the transudation of plasma through the vaginal epithelium.[26][
27][28]
Before and during ovulation, the cervix's mucus glands secrete different variati
ons of mucus, which provides an alkaline, fertile environment in the vaginal can
al that is favorable to the survival of sperm.[29] As women age, vaginal lubrica
tion decreases, which does not necessarily mean that a physical or psychological
problem exists.[30] After menopause, the body produces less estrogen, which, un
less compensated for with estrogen replacement therapy, causes the vaginal walls
to thin out significantly.[10][20][31]
Sexual activity
Further information: Human sexual activity and Human female sexuality
The concentration of the nerve endings near the entrance of the vagina (the lowe
r third) usually provide pleasurable vaginal sensations when stimulated during s
exual activity, and many women additionally derive pleasure from a feeling of cl
oseness and fullness during penetration of the vagina.[32][33] The vagina as a w
hole, however, lacks nerve endings, which commonly hinders a woman's ability to
receive sufficient sexual stimulation, including orgasm, solely from penetration
of the vagina.[32][33][34] Although some scientific examinations of vaginal wal
l innervation indicate no single area with a greater density of nerve endings, o
r that only some women have a greater density of nerve endings in the anterior v
aginal wall,[35][36] heightened sensitivity in the anterior vaginal wall is comm
on among women.[35][37] These cases indicate that the outer one-third of the vag
ina, especially near the opening, contains the majority of the vaginal nerve end
ings, making it more sensitive to touch than the inner (or upper) two-thirds of
the vaginal barrel.[32][34][38] This factor makes the process of child birth sig
nificantly less painful, because an increased number of nerve endings means that
there is an increased possibility for pain and pleasure.[32][39][40]
Besides penile penetration, there are a variety of ways that pleasure can be rec

eived from vaginal stimulation, including by masturbation, fingering, oral sex (

cunnilingus), or by specific sex positions (such as the missionary position or t
he spoons sex position).[41] Some women use sex toys, such as a vibrator or dild
o, for vaginal pleasure.[42] Foreplay is often used to incite sexual arousal, an
d may include one or more of the aforementioned sexual activities. The clitoris
additionally plays a part in vaginal stimulation, as it is a sex organ of multip
lanar structure containing an abundance of nerve endings, with a broad attachmen
t to the pubic arch and extensive supporting tissue to the mons pubis and labia;
it is centrally attached to the urethra, and research indicates that it forms a
tissue cluster with the vagina. This tissue is perhaps more extensive in some w
omen than in others, which may contribute to orgasms experienced vaginally.[34][
43][44]
During sexual arousal, and particularly the stimulation of the clitoris, the wal
ls of the vagina lubricate. This begins after ten to thirty seconds of sexual ar
ousal, and increases in amount the longer the woman is aroused.[45] It reduces f
riction or injury that can be caused by insertion of the penis into the vagina o
r other penetration of the vagina during sexual activity. The vagina lengthens d
uring the arousal, and can continue to lengthen in response to pressure; as the
woman becomes fully aroused, the vagina expands in length and width, while the c
ervix retracts.[45][46] With the upper two-thirds of the vagina expanding and le
ngthening, the uterus rises into the greater pelvis, and the cervix is elevated
above the vaginal floor, resulting in "tenting" of the mid-vaginal plane.[45] As
the elastic walls of the vagina stretch or contract, with support from the pelv
ic muscles, to wrap around the inserted penis (or other object),[38] this stimul
ates the penis and helps to cause the male to experience orgasm and ejaculation,
which in turn enables fertilization.[47]
An area in the vagina that may be an erogenous zone is the G-spot (also known as
the Grfenberg spot); it is typically defined as being located at the anterior wa
ll of the vagina, a couple or few inches in from the entrance, and some women ex
perience intense pleasure, and sometimes an orgasm, if this area is stimulated d
uring sexual activity.[35][37] A G-spot orgasm may be responsible for female eja
culation, leading some doctors and researchers to believe that G-spot pleasure c
omes from the Skene's glands, a female homologue of the prostate, rather than an
y particular spot on the vaginal wall; other researchers consider the connection
between the Skene's glands and the G-spot area to be weak.[35][36][37] The G-sp
ot's existence, and existence as a distinct structure, is still under dispute, a
s its reported location can vary from woman to woman, appears to be nonexistent
in some women, and it is hypothesized to be an extension of the clitoris and the
refore the reason for orgasms experienced vaginally.[35][39][44]
Childbirth
The vagina provides a channel to deliver a newborn from the uterus to its indepe
ndent life outside the body of the mother. When childbirth (or labor) nears, sev
eral symptoms may occur, including Braxton Hicks contractions, vaginal discharge
, and the rupture of membranes (water breaking).[48] When water breaking happens
, there may be an uncommon wet sensation in the vagina that is an irregular or s
teady small stream of fluid from the vagina, or a gush of fluid.[49][50]
When the body prepares for childbirth, the cervix softens, thins, moves forward
to face anteriorly, and may begin to open. This allows the fetus to settle or "d
rop" into the pelvis.[48] When the fetus settles into the pelvis, this may resul
t in pain in the sciatic nerves, increased vaginal discharge, and increased urin
ary frequency. While, for women who have given birth before, these symptoms are
likelier to happen after labor has already begun, they may happen approximately
ten to fourteen days before labor in women experiencing the effects of nearing l
abor for the first time.[48]
The fetus begins to lose the support of the cervix when uterine contractions beg

in. With cervical dilation reaching a diameter of more than 10 cm (4 in) to acco
mmodate the head of the fetus, the head moves from the uterus to the vagina.[48]
The elasticity of the vagina allows it to stretch to many times its normal diam
eter in order to deliver the child.[16]
Births are usually successful vaginal births, but there are sometimes complicati
ons and a woman may undergo a caesarean section instead of a vaginal delivery. T
he vaginal mucosa has an abnormal accumulation of fluid (edematous) and is thin,
with few rugae, a little after birth. The mucosa thickens and rugae return in a
pproximately three weeks once the ovaries regain usual function and estrogen flo
w is restored. The vaginal opening gapes and is relaxed, until it returns to its
approximate pre-pregnant state by six to eight weeks in the period beginning im
mediately after the birth (the postpartum period); however, it will maintain a l
arger shape than it previously had.[51]
Vaginal ecosystem and acidity
Main article: Vaginal flora
The vagina is a nutrient rich environment that harbors a unique and complex micr
obiome. It is a dynamic ecosystem that undergoes long-term changes, from neonate
to puberty and from the reproductive period (menarche) to menopause. Moreover,
under the influence of hormones, such as estrogen (estradiol), progesterone and
follicle-stimulating hormone (FSH), the vaginal ecosystem undergoes cyclic or pe
riodic changes, i.e. during menses and pregnancy.[52] One significant variable p
arameter is the vaginal pH, which varies significantly during a woman's lifespan
, from 7.0 in premenarchal girls, to 3.8-4.4 in women of reproductive age to 6.5
-7.0 during menopause without hormone therapy and 4.5-5.0 with hormone replaceme
nt therapy.[53] Estrogen, glycogen and lactobacilli are important factors in thi
s variation.[52][53]
Clinical significance
General
An ultrasound showing the urinary bladder (1), uterus (2), and vagina (3)
The vagina is self-cleansing and therefore usually does not need special hygiene
. To maintain vulvovaginal health, doctors generally discourage the practice of
douching.[54] Since a healthy vagina is colonized by a mutually symbiotic flora
of microorganisms that protect its host from disease-causing microbes, any attem
pt to upset this balance may cause many undesirable outcomes, including but not
limited to abnormal discharge and yeast infection.[54]
The vagina and cervix are examined during gynecological examinations of the pelv
is, often using a speculum, which holds the vagina open for visual inspection or
taking samples (see pap smear).[55] This and other medical procedures involving
the vagina, including digital internal examinations and administration of medic
ine,[55][56] are referred to as being "per vaginam", the Latin for "via the vagi
na",[57] often abbreviated to "p.v.".[56]
A disposable plastic bi-valved vaginal speculum used in gynecological examinatio
n
The healthy vagina of a woman of child-bearing age is acidic, with a pH normally
ranging between 3.8 and 4.5., and this is due to the degradation of glycogen to
the lactic acid by enzymes secreted by the Dderlein's bacillus, which is a norma
l commensal of the vagina.[52] The acidity retards the growth of many strains of
pathogenic microbes.[52] An increased pH of the vagina (with a commonly used cu
t-off of pH 4.5 or higher) can be caused by bacterial overgrowth, as occurs in b
acterial vaginosis and trichomoniasis, or rupture of membranes in pregnancy.[52]
[58]
Intravaginal administration is a route of administration where the substance is

applied to the inside of the vagina. Pharmacologically, it has the potential adv
antage to result in effects primarily in the vagina or nearby structures (such a
s the vaginal portion of cervix) with limited systemic adverse effects compared
to other routes of administration.[59][60]
Infections and disorders
Main article: Vaginal disease
There are many infections, diseases and disorders that can affect the vagina, in
cluding candidal vulvovaginitis, vaginitis, vaginismus, sexually transmitted inf
ections (STIs) or cancer. Vaginitis is an inflammation of the vagina, and is att
ributed to several vaginal diseases, while vaginismus is an involuntary tighteni
ng of the vagina muscles caused by a conditioned reflex, or disease, during vagi
nal penetration.[61] HIV/AIDS, human papillomavirus (HPV), genital herpes and tr
ichomoniasis are some of the STIs that may affect the vagina, and health authori
ties and health care providers recommend safe sex practices when engaging in sex
ual activity to prevent STIs.[62][63] Cervical cancer may be prevented by pap sm
ear screening and HPV vaccines. Vaginal cancer is very rare, and is primarily a
matter of old age; its symptoms include abnormal vaginal bleeding or vaginal dis
charge.[64][65]
There can be a vaginal obstruction, such as one caused by agenesis, an imperfora
te hymen or, less commonly, a transverse vaginal septum; these cases require dif
ferentiation because surgery for them significantly varies.[66] When there is a
lump obstructing the vaginal opening, it is likely a Bartholin's cyst.[67] Vagin
al prolapse is characterized by a portion of the vaginal canal protruding (prola
psing) from the opening of the vagina. It may result in the case of weakened pel
vic muscles, which is a common result of childbirth; in the case of this prolaps
e, the rectum, uterus, or bladder pushes on the vagina, and severe cases result
in the vagina protruding out of the body. Kegel exercises have been used to stre
ngthen the pelvic floor, and may help prevent or remedy vaginal prolapse.[68]
Modification
The vagina, including the vaginal opening, may be altered as a result of genital
modification during vaginoplasty or labiaplasty; for example, alteration to the
inner labia (also known as the vaginal lips or labia minora). There is no evide
nce that such surgery improves psychological or relationship problems; however,
the surgery has a risk of damaging blood vessels and nerves.[69]
Female genital mutilation (FGM), another aspect of female genital modification,
may additionally be known as female circumcision or female genital cutting (FGC)
.[70][71] FGM has no known health benefits. The most severe form of FGM is infib
ulation, in which there is removal of all or part of the inner and outer labia (
labia minora and labia majora) and the closure of the vagina; this is called Typ
e III FGM, and it involves a small hole being left for the passage of urine and
menstrual blood, with the vagina being opened up for sexual intercourse and chil
dbirth.[71]
Society and culture
Biological perceptions, symbolism and vulgarity
There have been various perceptions of the vagina throughout history, including
that it is the center of sexual desire, a metaphor for life via birth, inferior
to the penis, visually unappealing, inherently "smelly," or otherwise vulgar.[72
][73][74] These views can largely be attributed to sex differences, and how they
are interpreted. David Buss, an evolutionary psychologist, stated that because
a penis is significantly larger than a clitoris and it is "on display and ready
to be noticed" while the vagina is not, and males urinate through the penis, boy
s are taught from childhood "to touch and hold their penises" while girls are of
ten taught that they should not touch their own genitals, "as if their genitals
were a biohazard zone." Buss attributed this to the reason why many women are no
t as familiar with their genitalia as men are familiar with their own, and that

researchers assume these sex differences explain why boys learn to masturbate be
fore girls, and masturbate more often than girls.[75]
The word vagina is commonly avoided in conversation,[76] and many men in additio
n to women do not know that the vagina is not used for urination.[77][78][79] Th
is is exacerbated by the phrase "Boys have a penis, girls have a vagina.", which
causes children to think that girls have one orifice in the pelvic area.[78] Au
thor Hilda Hutcherson stated, "Because many of us [women] have been conditioned
since childhood through verbal and nonverbal cues to think of our genitals as ug
ly, smelly and unclean, we aren't able to fully enjoy intimate encounters becaus
e of fear that our partner will be turned off by the sight, smell, and taste of
our genitals." She added that women, unlike men, did not have locker room experi
ences in school where they compared each other's genitals, and so many women won
der if their genitals are normal.[73] Scholar Catherine Blackledge stated that h
aving a vagina meant she would typically be treated less well than a "vagina-les
s person" and that she "could be expected to work all [her] life for less money
than if [she] was minus female genitalia"; it meant she "could expect to be trea
ted as a second-class citizen".[76]
Negative views of the vagina are simultaneously contrasted by views that it is a
powerful symbol of female sexuality, spirituality, or life. Author Denise Linn
stated, "[The vagina] is a powerful symbol of womanliness, openness, acceptance,
and receptivity. It is the inner valley spirit."[80] Sigmund Freud placed signi
ficant value on the vagina,[81] postulating the concept of vaginal orgasm, that
it is separate from clitoral orgasm, and that, upon reaching puberty, the proper
response of mature women is a change-over to vaginal orgasms (meaning orgasms w
ithout any clitoral stimulation). This theory, however, made many women feel ina
dequate, as the majority of women cannot achieve orgasm via vaginal intercourse
alone.[82][83][84] Regarding religion, the vagina represents a powerful symbol a
s the yoni in Hindu, and this may indicate the value that Hindu society has give
n female sexuality and the vagina's ability to birth life.[85]
In Ancient times, the vagina was often considered equivalent (homologous) to the
penis; anatomists Galen (129 AD
200 AD) and Vesalius (1514 1564), regarded the or
gans as structurally the same, except for the vagina being inverted. Anatomical
studies over latter centuries, however, showed the clitoris to be the penile equ
ivalent.[43][86] The release of vaginal fluids were considered by medical practi
tioners to cure or remedy a number of ailments; various methods were used over t
he centuries to release "female seed" (via vaginal lubrication or female ejacula
tion) as a treatment for suffocation ex semine retento (suffocation of the womb)
, female hysteria or green sickness. Methods included a midwife rubbing the wall
s of the vagina or insertion of the penis or penis-shaped objects into the vagin
a. Supposed symptoms of female hysteria included faintness, nervousness, insomni
a, fluid retention, heaviness in abdomen, muscle spasm, shortness of breath, irr
itability, loss of appetite for food or sex, and "a tendency to cause trouble".[
87] Women considered suffering from the condition would sometimes undergo "pelvi
c massage" stimulation of the genitals by the doctor until the woman experienced
"hysterical paroxysm" (i.e., orgasm). Paroxysm was regarded as a medical treatm
ent, and not a sexual release.[87] The categorization of female hysteria has cea
sed to be recognized as a medical condition since the 1920s.
The vagina has additionally been termed many vulgar names,[88] two being cunt an
d pussy. Cunt is used as a derogatory epithet referring to people of either sex.
This usage is relatively recent, dating from the late nineteenth century.[89] R
eflecting different national usages, cunt is described as "an unpleasant or stup
id person" in the Compact Oxford English Dictionary, whereas Merriam-Webster has
a usage of the term as "usually disparaging and obscene: woman",[90] noting tha
t it is used in the U.S. as "an offensive way to refer to a woman";[91] and the
Macquarie Dictionary of Australian English states that it is "a despicable man".
When used with a positive qualifier (good, funny, clever, etc.) in Britain, New

Zealand and Australia, it can convey a positive sense of the object or person r
eferred to.[92] Pussy, on the other hand, can indicate "cowardice or weakness",
and "the human vulva or vagina" or by extension "sexual intercourse with a woman
".[93]
In contemporary art and literature
The Vagina Monologues, a 1996 episodic play by Eve Ensler, has successfully cont
ributed to making female sexuality a topic of public discourse. It is made up of
a varying number of monologues read by a number of women. Initially, Ensler per
formed every monologue herself, with subsequent performances featuring three act
resses; latter versions feature a different actress for every role. Each of the
monologues deals with an aspect of the feminine experience, touching on matters
such as sexual activity, love, rape, menstruation, female genital mutilation, ma
sturbation, birth, orgasm, the various common names for the vagina, or simply as
a physical aspect of the body. A recurring theme throughout the pieces is the v
agina as a tool of female empowerment, and the ultimate embodiment of individual
ity.[88][94]
In Japan, artist Megumi Igarashi has drawn attention for her work featuring vagi
nas, which she considers "overly hidden" in Japan compared to male genitalia.[95
]
Reasons for vaginal modification
Reasons for modification of the external female genitalia includes voluntary cos
metic operations and surgery for intersex conditions, which can involve surgery
to the vagina, labia minora, or clitoris.[69] It also includes FGM.[96] There ar
e two main categories of women seeking cosmetic genital surgery: those with cong
enital conditions such as an intersex condition, and those with no underlying co
ndition who experience physical discomfort or wish to alter the appearance of th
eir genitals because they believe they do not fall within a normal range.[69]
Significant controversy surrounds FGM,[70][71] with the World Health Organizatio
n (WHO) being one of many health organizations that have campaigned against the
procedures on behalf of human rights, stating that it is "a violation of the hum
an rights of girls and women" and "reflects deep-rooted inequality between the s
exes".[71] FGM has existed at one point or another in almost all human civilizat
ions,[96] most commonly to exert control over the sexual behavior, including mas
turbation, of girls and women.[71][96] It is carried out in several countries, e
specially in Africa, and to a lesser extent in other parts of the Middle East an
d Southeast Asia, on girls from a few days old to mid-adolescent, often to reduc
e sexual desire in an effort to preserve vaginal virginity.[70][71][96] It may a
lso be that FGM was "practiced in ancient Egypt as a sign of distinction among t
he aristocracy"; there are reports that traces of infibulation are on Egyptian m
ummies.[96]
Custom and tradition are the most frequently cited reasons for FGM, with some cu
ltures believing that not performing it has the possibility of disrupting the co
hesiveness of their social and political systems, such as FGM also being a part
of a girl's initiation into adulthood.[71][96] Often, a girl is not considered a
n adult in a FGM-practicing society unless she has undergone FGM.[71]
Other animals
See also: Sex organs Mammals
The vagina is a general feature of animals in which the female is internally fer
tilized (other than by traumatic insemination). The shape of the vagina varies a
mong different animals.
In placental mammals and marsupials, the vagina leads from the uterus to the ext
erior of the female body. Female marsupials have two lateral vaginas, which lead
to separate uteri, but both open externally through the same orifice.[97] The u

rethra and vagina of the female spotted hyena exits through the clitoris, allowi
ng the females to urinate, copulate and give birth through the clitoris.[98] The
canine female vagina contracts during copulation, forming a copulatory tie.[99]
In birds, monotremes, and some reptiles, a homologous part of the oviduct leads
from the shell gland to the cloaca.[100][101] In some jawless fish, there is nei
ther oviduct nor vagina and instead the egg travels directly through the body ca
vity (and is fertilised externally as in most fish and amphibians). In insects a
nd other invertebrates, the vagina can be a part of the oviduct (see insect repr
oductive system).[102] Females of some waterfowl species have developed vaginal
structures called dead end sacs and clockwise coils to protect themselves from s
exual coercion.[103]
In 2014, the scientific journal Current Biology reported that four species of Br
azilian insects in the genus Neotrogla were found to have sex-reversed genitalia
. The male insects of those species have vagina-like openings, while the females
have penis-like organs.[104][105][106]